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Community Care (Delayed Discharges etc.) Bill



COMMONS REASONS FOR DISAGREEING TO CERTAIN LORDS AMENDMENTS AND

COMMONS AMENDMENTS TO CERTAIN OTHER LORDS AMENDMENTS

[The page and line references are to HL Bill 20 as first printed for the Lords.]

Clause 1

LORDS AMENDMENT NO. 2

Page 1, line 10, after “person” insert “other than a person receiving mental health

 

services”

 

The Commons disagree to this amendment for the following Reason

2A

Because it is important for the Bill to be able to apply to all NHS hospital patients and it is

 

discriminatory to exclude patients receiving mental health services.

Clause 2

LORDS AMENDMENT NO. 5

Page 2, line 5, after “hospital” insert “after 1st April 2004”

 

The Commons disagree to this amendment for the following Reason

5A

Because it is necessary for the Bill to come into force before 1st April 2004.

 

LORDS AMENDMENT NO. 6

Page 2, line 8, at end insert—

 

                  “and

 

                  (ii)                    has consulted with the patient (and in the case of a carer in

 

relation to assessment under the Carers (Recognition and

 

Services) Act 1995 (c. 12) and the Carers and Disabled

 

Children Act 2000 (c. 16)) to ascertain their views and

 

preferences, informed them of the reason for the

 
HL Bill 4853/2

 

    (  2  )

 
 

notification, and obtained their informed consent or in the

 

case where a patient lacks the mental capacity to give such

 

consent, has recorded on the file what steps have been taken

 

to ensure that the patient’s best interests have been duly

 

considered”

 

The Commons disagree to this amendment for the following Reason

6A

Because it is unnecessary to require consent for the giving of notices containing no personal

 

information and because Lords Amendment No. 9 makes more appropriate provision for

 

consultation.

Clause 3

LORDS AMENDMENT NO. 14

Page 2, line 41, after “consulting” insert “the patient and having obtained the

 

informed consent of the patient or, in the case where a patient lacks the mental

 

capacity to give such consent to the proposed care plan, having recorded on the file

 

what steps have been taken to ensure that the patient’s best interests have been

 

duly considered, and after consulting”

 

The Commons disagree to this amendment for the following Reason

14A

Because it is unnecessary to add additional requirements in relation to community care

 

assessments under clause 3(3) and it is undesirable to differentiate between assessments

 

under clause 3(3) and other assessments carried out under section 47 of the National

 

Health Service and Community Care Act 1990.

 

LORDS AMENDMENT NO. 15

Page 2, line 41, after “body” insert “and the qualifying patient”

 

The Commons disagree to this amendment for the following Reason

15A

Because it is unnecessary to add additional requirements in relation to community care

 

assessments under clause 3(3) and it is undesirable to differentiate between assessments

 

under clause 3(3) and other assessments carried out under section 47 of the National

 

Health Service and Community Care Act 1990.

 

LORDS AMENDMENT NO. 16

Page 2, line 42, at end insert—

 

     “( )       Before making a decision under subsection (3), the responsible authority

 

must—

 

           (a)           consult the patient and his carer, if he has one;

 

           (b)           inform them of the cost of the proposed care plans; and

 

           (c)           obtain the consent of the patient and any carer and, where informed

 

consent is given, record that on the patient’s file, or if a patient lacks

 

the mental capacity to give such consent, record on the file what

 

steps it has taken to ensure that the patient’s best interests have

 

been duly considered.”

 

The Commons disagree to this amendment for the following Reason

16A

Because it is unnecessary to add additional requirements in relation to community care


 

    (  3  )

 
 

assessments under clause 3(3) and it is undesirable to differentiate between assessments

 

under clause 3(3) and other assessments carried out under section 47 of the National

 

Health Service and Community Care Act 1990.

 

LORDS AMENDMENT NO. 18

Page 3, line 8, after “consulting” insert “the carer and obtaining the informed

 

consent of the carer to the proposed care plan and after consulting”

 

The Commons disagree to this amendment for the following Reason

18A

Because it is unnecessary to add additional requirements in relation to carers’ assessments

 

under clause 3(4) and it is undesirable to differentiate between assessments under clause

 

3(4) and other assessments carried out under the Carers and Disabled Children Act 2000.

 

LORDS AMENDMENT NO. 23

Page 3, line 37, at end insert—

 

     “( )       The responsible NHS body must give the patient and his carer, if he has

 

one—

 

           (a)           notice of the day on which it proposes to discharge the patient, and

 

where informed consent is given, record that on the patient’s file, or

 

if a patient lacks the mental capacity to give such consent, record on

 

the file what steps it has taken to ensure that the patient’s best

 

interests have been duly considered, and

 

           (b)           information about their right to request a review if they disagree

 

with the decision to discharge.”

 

The Commons disagree to this amendment for the following Reason

23A

Because the decision to discharge should not be subject to the consent of the patient and it

 

is undesirable to discriminate on this issue between patients who are subject to the Bill and

 

other hospital patients.

 

LORDS AMENDMENT NO. 24

Page 3, line 45, at end insert—

 

     “( )       The Secretary of State shall specify to the bodies charged with inspection of

 

health and social services that they should monitor, at regular intervals, the

 

impact of this Act on patients and their carers.”

 

The Commons disagree to this amendment for the following Reason

24A

Because the inspection and monitoring system for health and social care services is

 

adequate and the amendment is unnecessary.

 

LORDS AMENDMENT NO. 25

Page 3, line 45, at end insert—

 

     “( )       The Secretary of State shall report on an annual basis to Parliament on the

 

outcomes of patients affected by this Act.”

 

The Commons disagree to this amendment for the following Reason

25A

Because the inspecting bodies for health and social care services will be able to make reports


 

    (  4  )

 
 

on the operation of the Bill.

After Clause 3

LORDS AMENDMENT NO. 26

Insert the following new Clause—

 

“ Duties of responsible NHS body following notice under section 2

 

     (1)    The duties under this section apply where notice of a patient’s case under

 

section 2 has been given.

 

     (2)    The responsible NHS body, and any other NHS body which is considering

 

whether to provide services to the patient after discharge, must consult the

 

responsible authority before deciding what services (if any) it will make

 

available to him in order for it to be safe to discharge the patient.

 

     (3)    The responsible NHS body must give the responsible authority notice of

 

the day on which it proposes to discharge the patient.

 

     (4)    The notice under subsection (3) remains in force until the end of the

 

relevant day, unless it has previously been withdrawn.

 

     (5)    The responsible NHS body may withdraw the notice under subsection (3)

 

at any time before the end of the relevant day by giving notice of

 

withdrawal to the responsible authority.

 

     (6)    For the purposes of this Part “the relevant day”, in relation to a qualifying

 

hospital patient, is the later of—

 

           (a)           the day specified in the notice under subsection (3); and

 

           (b)           the last day of the prescribed minimum interval after the notice

 

under section 2 is given.

 

     (7)    Regulations may prescribe a period as the minimum interval after a notice

 

under section 2 is given; but that period must—

 

           (a)           begin with the day after that on which the notice under section 2 is

 

given; and

 

           (b)           be a period of at least two days excluding Saturdays, Sundays and

 

public holidays.

 

     (8)    If the notice under subsection (3) is withdrawn before the end of the

 

relevant day—

 

           (a)           the duty under subsection (3) applies again; and

 

           (b)           when a fresh notice under subsection (3) is given, subsection (6)

 

applies again for the purpose of identifying a new “relevant day”.

 

     (9)    Regulations may provide for—

 

           (a)           the time at which notices under subsection (3) are to be given;

 

           (b)           the form and content of—

 

                  (i)                 notices under subsection (3); and

 

                  (ii)                withdrawal notices under subsection (5);

 

                         and the manner in which such notices are to be given;

 

           (c)           circumstances in which notices under subsection (3) must be

 

withdrawn; and


 

    (  5  )

 
 

           (d)           determining the day on which a notice under subsection (3) or a

 

notice of withdrawal under subsection (5) is given (including

 

provision prescribing circumstances in which a notice under

 

subsection (3) is to be treated for any specified purpose as having

 

been given on a day other than that on which it was in fact given).”

 

The Commons agree to this amendment with the following amendment

26A

Line 25, leave out “excluding Saturdays, Sundays and public holidays”

After Clause 4

LORDS AMENDMENT NO. 35

Insert the following new Clause—

 

“Delayed discharge payments: supplementary

 

     (1)    In prescribing an amount under section 4(4) the appropriate Minister must

 

have regard (among other things) to either or both of the following

 

matters—

 

           (a)           costs to NHS bodies of providing accommodation and personal

 

care to patients who are ready to be discharged; and

 

           (b)           costs to social services authorities of providing community care

 

services to, and services to carers in relation to, persons who have

 

been discharged.

 

     (2)    Any payment which the responsible authority is required to make under

 

section 4 in relation to a qualifying hospital patient shall, subject to

 

subsection (2), be made to the responsible NHS body.

 

     (3)    In case of any description prescribed in regulations the payment shall be

 

made to the person prescribed in relation to cases of that description.

 

     (4)    Section 4 shall not come into force until 30 days after the Secretary of State

 

has determined that the systems of incentives within NHS bodies operate

 

to discourage NHS bodies from discharging patients inappropriately.”

 

The Commons agree to this amendment with the following amendment

35A

Line 16, leave out subsection (4)

After Clause 17

LORDS AMENDMENT NO. 47

Insert the following new Clause—

 

“Duration

 

     (1)    Subject to subsection (2), Part 1 of this Act shall cease to have effect at the

 

end of five years beginning with the date on which it comes into force.

 

     (2)    If the Secretary of State is satisfied that it is necessary for social services

 

authorities to continue making payments in cases where the discharge of

 

patients is delayed for reasons relating to the provision of community care


 

    (  6  )

 
 

services or services for carers, he may make an order providing that Part 1

 

of this Act shall continue in force for a further five years.

 

     (3)    An order may not be made under subsection (2) unless a draft of that order

 

has been laid before, and approved by resolution of, both Houses of

 

Parliament.”

 

The Commons disagree to this amendment for the following Reason

47A

Because the provisions of Part I should not be made to have only temporary effect.


 
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